| NPI | 1073268058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA REEDINGER Member 678-451-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-02-17 |